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1991, 12-04 Permit App: 91008378 Mechanical-�;2 �s1�e�t�go0 ` 1eS{ MECHANICAL PERMIT APPLICATION FORM (b a `- Information Worksheet {STREET;' ADDRESS : �`�id,VO'in �`�rY'SjE +t t r- qvr .•.: ,... �� C� _ PARCEL Nl >TATE%,ZIP.:' s: a ;. hsr' 1 :gFS° w 3T ,r ; Alm PHONE . Nl M JG ADDR SS : ACTOR'.: ° M LICENSE`,' PHONE t_ IG ADDRESS"•` (Street); s l�y07� (aity/State) - 1, (Zip) . wt� , 7< {h; ,qMECHANICAL WORKSHEET/FEELSCHEDULE' WLTrIBEk A EACI n,`4: DESCRIPTION. OF � UNI'TS UNIT = AMOUNT yDUCTWORK SYSTEM_=y=, x$10.00 " 'OODSTOVE/.-INSERTt �- x. 25.0.0 = fist. X`10. 0 0 — 'n _ 'HEATING EQUIPMENT ,<100,`000 ; BTU a " x'12.00 = HEATING EQUIPMENT +100, 0.00,, BTU t• 5y_ x 15.00 = X'1.00_1PI0;cj RE.FRIG 14100K, BTU.(NOT3A/C OR HEAV PUMP) " x 12.00 = RIG,'101 5a _4 u X 20.00 = REFRIG, 501-1; 000M BTU —_ G x. 25..00 = rREFRIGw1,'001r1,-750M: BTU x 35:00 = x � 60.00 IG `!REFR; 4.1 7.50M _ ° HEAT^PUMP`&' eAIR- CONDITIONER 073 TO `' x'12..00 — $ nfHEATh,PUMP&AIRS CONDITIONER 3-15 TONSY x 20.00 = HEATc 'PUMP :&FAIR-��CONDITIONER 15-30y TONS x.'25.00 = j �y.. X'35.00 - .= " HEAT�yPUMP �&I AIR CONDITIONER 30-50 TONS HEAT PUMP '&' AIR' CONDITIONER +50 TONS, x 60:00 = VENTILATINGFANS+rYst_"r _ rg X :10 00 :_ EVAPORATIVE COOLERS"r`z-' — — ' _ `'` x 10:00 = �' ' TYPE `I HOODr (PER 12' ,OR�f121 PTN. `. OF HOOD) Jl , x• 50:00 = TY=PEzII FIi00D ;i�'5`f r x 10.00 4CIATIiES�x,DRYERY"'`3�X 5°RANGE` n „,'� ��i; ``saw r x 10 ;0 0 = GABS LOG :•�L:Y? 5� t ; � 00 _ 1 MISCEILANEOUS+z(NOT` COVERED,:ELSEWHERE)jil UNLISTED,GASAPPLtrIANCE,<40,0, 000 BTU ,, UNLISTED�GAS yAPPLIANCE>4'00, 000BTU k f x100 : 00, = r, -USEDAPPLIANCE ' "<4i00" BTU_ '^ ° �` �'b0s'T �. ,k '�E x 50.00 za k u a N = ,� + USED &APPLhANCE`Q >400' 000, ,BTU 'r s" x100 00 AIR�.HANDLER <TO 000 }CFM`x • _ >i r' x 12.00_= { AIRHANDLERw>10', x `.15.'00 = 1 x} `s'� : j,Y r b� �M' a� SUBTOTAL $ �+k�'.!',�r r .'rr°.3ir��ay r "��' 3? PLUS PROCESSING FEE +' $.. 25:'00 L p Ik 1 ,. a,irl�z?.wyttiI s't �,z=, ar EQUALS TOTAL PERMIT .i..Y"'+rFss! w yr7yq$., n L -Y. r k' C tJ NO • } MIN MUMFEE I $35:00 FEE". DUE ' SIGNATURE Ie 54 g fie",County Department of Buildingg and Safety 13 3 Broadway Avenue;. Spokane,:": WA 93260/`'... (509) 456-3675